Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 14100111 | SC |
Y | 101YP2500X | Professional Counselor | 4111 | SC |
NPI | 1003893744 |
---|---|
Provider Name | Ms. Kristi Faye Padgett |
First Address | Easley, SC 29642 |
Second Address | Anderson, SC 29625-2104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2005 |
Last Update Date | 17/03/2018 |